Clinical Services Capability Framework

The SA Health Clinical Services Capability Framework (CSCF) 2016 sets out the planned structure of public health services across South Australia. It is an important tool for state-wide strategic planning and supports the implementation of Transforming Health by defining the criteria and capabilities required for health services to achieve safe and supported clinical service delivery. It also provides planners and clinicians with a consistent approach to the way clinical services are described and identifies interdependencies that exist between clinical areas.

The CSCF comprises of 29 service modules, which outline a standard set of capability criteria and support services needed to achieve high quality health services. The CSCF has been developed as a tool to assist health service planning so should be interpreted as a guide only.It is not intended to replace existing guidelines, policy directives, frameworks or industrial instruments.

The Cancer Services preamble defines the scope of the cancer services modules.There are five modules relating directly to cancer services, as well as a Palliative Care module and Surgical Oncology sub-section to the Surgical Services module.

The Children’s Services preamble defines the scope of the children’s services modules, and recognises the unique needs and vulnerabilities of children. There are seven modules specific to children, as well as sections within the Mental Health Services module.

The Cancer Services - Children module recognises the complexity and severity of treating systemic cancer, and the subsequent demand for sufficient resource to deliver effective therapy and supportive care.The CSCF outlines three levels of complexity for paediatric cancer services.

The Cancer Services - Radiation Oncology module addresses service provision relevant to those with cancer requiring radiotherapy. Safety measures, and equipment and infrastructural requirements are detailed within the module. The CSCF outlines two levels of complexity for radiation oncology services.

The Cancer Services - Radiation Oncology - Children module recognises the delivery of radiotherapy for children requiring specialised equipment and facilities, and support from numerous clinical specialities and services. The CSCF outlines two levels of complexity for radiation oncology services for children.

The Cardiac Services module recognises the diagnosis, management and treatment of patients with a wide range of cardiac and/or coronary artery disease.

The CSCF outlines three levels of complexity for cardiac (coronary) care unit services, four levels of complexity for cardiac diagnostic and interventional services, four levels of complexity for cardiac medicine services, three levels of complexity for cardiac rehabilitation services, and one level of service (level six) for cardiac surgery services.

The Emergency Services module focusses on services that have a direct impact on the ability of Emergency Departments to deliver safe and advanced care within a clinical appropriate timeframe and environment. It recognises that Emergency Departments are not stand-alone facilities, but rely upon a suite of support services both within and external to the organisation. The CSCF outlines six levels of complexity for emergency services.

The Emergency Services - Children module addresses the reception, triage, initial assessment, stabilisation, management and referral of children presenting with acute and urgent aspects of illness and injury. The CSCF outlines three levels of complexity for children’s emergency services.

The specialty of General Medicine provides comprehensive care for a wide variety of adults with complex medical and social needs. Patients of General Medicine typically have a range of acute exacerbations amidst chronic conditions, a condition known as multimorbidity, which can make identification of the principal diagnosis and management challenging. General Medicine addresses these challenges through diagnostic rigor and individualised care.

The Geriatric Medicine module addresses service provision for those typically with a range of complex chronic conditions overlaid by functional decline / frailty, frequent falls, dementia, delirium and incontinence. This module recognises the need for a coordinated multidisciplinary team, who collectively are able to address the physical, psychological, social and cultural aspects of care. The CSCF outlines six levels of complexity for geriatric medicine services.

The Intensive Care Services module addresses service delivery for those with established life-threatening reversible or potentially reversible organ failure, or with a high risk of life-threatening organ failure. The CSCF recognises three levels of complexity for intensive care services.

The Intensive Care Services - Children module recognises the capabilities required to provide clinical expertise to support children with life-threatening, reversible, or potentially life-threatening and reversible, organ failure.The CSCF recognises three levels of complexity for intensive care services for children.

The Maternity and Neonatal Services module is based on the SA Health Standards for Maternity and Neonatal Services in South Australia 2015.It is recommended that this module be read in conjunction with these standards in their entirety. The CSCF recognises six levels of complexity for maternity and neonatal services.

The Medical Services module addresses a broad range of internal medicine services. This module focusses on the prevention, early detection and management of acute and chronic disease, and recognises effective procedures and practices essential for all medical services. The CSCF recognises six levels of complexity for medical services.

The Mental Health Services module addresses the assessment, diagnosis, monitoring and treatment of people who have a mental illness or disorder characterised by a clinically significant disturbance of thought, mood, perception, memory and/or behaviour.The CSCF recognises six levels of complexity for ambulatory services, five levels of complexity for acute inpatient services, four levels of complexity for perinatal and infant services, three levels of complexity for adult non-acute inpatient services and two levels of complexity for emergency service-short stay services.

The Nuclear Medicine Services module addresses the use of radiopharmaceuticals to diagnose and treat adults and children with a variety of disease processes.The CSCF recognises three levels of complexity for nuclear medicine services.

The Palliative Care module addresses service provision for those who are expected to die in the near future due to a progressive, life-limiting illness, and support for the person’s family and/or caregivers. The CSCF recognises four levels of complexity for palliative care services.

The Perioperative Services module addresses service delivery relevant to those preparing for, undergoing and recuperating from surgery. This module applies to adults and children and is primarily focussed on the provision of elective surgery. The CSCF recognises two levels of complexity for acute pain services, two levels of complexity for day surgery services, four levels of complexity for endoscopy services, five levels of complexity for operating suite services, and four levels of complexity for post-anaesthetic care.

The Pharmacy Services module addresses a range of activities designed to enhance the safe and effective use of medicines to optimise patient outcomes. The CSCF recognises six levels of complexity for pharmacy services.

The Rehabilitation Services module addresses service delivery relevant to children and adults with a range of functional impairments across physical and psychological domains, arising from acute or sub-acute conditions, accidents or congenital abnormalities. The CSCF recognises six levels of complexity for rehabilitation services.

This module recognises six levels of complexity for stroke service provision, and incorporates the service delineation outlined in the National Acute Stroke Services Framework 2015. The different service levels take into consideration the complexity and risks associated with the delivery of a service and the need for specialised support.

The Surgical Services module focusses primarily upon the provision of elective surgical services for adults, however does encompass both elective and emergency surgery. The capacity of a service to efficiently manage patients requiring surgery depends upon the service having an efficient interface with a range of other hospital and community based services. The CSCF recognises five levels of complexity for surgical services, and includes a Surgical Oncology subspecialty.

The Surgical Services - Children module focusses primarily upon the provision of elective surgical services for children, however does encompass both elective and emergency surgery. The capacity of children’s surgical services to provide efficient and safe surgery depends on the child’s age, presence of comorbidities and type of surgery required.The CSCF recognises five levels of complexity for children’s surgical services.